Cargando…
Diagnostic challenges of celiac disease in a young child: A case report and a review of the literature
RATIONALE: Celiac disease is a chronic, immune-mediated, multiorgan disorder that affects susceptible individuals, and it is triggered by gluten and other prolamins. PATIENT CONCERNS: We present the case of a 1-year-old male child, with a history of idiopathic pericardial effusion, admitted in our c...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392781/ https://www.ncbi.nlm.nih.gov/pubmed/29851812 http://dx.doi.org/10.1097/MD.0000000000010893 |
_version_ | 1783398551159570432 |
---|---|
author | Mărginean, Cristina Oana Meliţ, Lorena Elena Stefănuţ Săsăran, Vlăduţ Mărginean, Cristian Dan Mărginean, Maria Oana |
author_facet | Mărginean, Cristina Oana Meliţ, Lorena Elena Stefănuţ Săsăran, Vlăduţ Mărginean, Cristian Dan Mărginean, Maria Oana |
author_sort | Mărginean, Cristina Oana |
collection | PubMed |
description | RATIONALE: Celiac disease is a chronic, immune-mediated, multiorgan disorder that affects susceptible individuals, and it is triggered by gluten and other prolamins. PATIENT CONCERNS: We present the case of a 1-year-old male child, with a history of idiopathic pericardial effusion, admitted in our clinic for severe abdominal bloating, irritability, loss of appetite and intermittent diarrheic stools. The clinical findings were: influenced general status, irritability, distended abdomen, and diffuse abdominal tenderness. DIAGNOSES: The initial laboratory tests revealed anemia, leukocytosis, increased inflammatory biomarkers, high levels of transaminases, and hypoalbuminemia. The stool culture identified an enterocolitis with enteropathogenic Escherichia coli (E. coli). INTERVENTIONS: We initiated antibiotic treatment, substitution therapy with human albumin and probiotics with initial favorable evolution, but after 1 month, the patient was re-admitted for the persistence of intermittent diarrheic stools and abdominal bloating, when we established the diagnosis of cow's milk protein allergy. We initiated diary-free diet. OUTCOMES: Unfortunately, the patient was re-admitted after another 8 months, presenting the same clinical and laboratory findings as during the initial admission. We repeated the serology for celiac disease and we performed an upper gastrointestinal endoscopy with duodenal biopsies, which established the diagnosis of celiac disease. After 1 month of gluten-free diet, the patient's evolution improved considerably. LESSONS: Enterocolitis with E. coli could be considered as trigger for CD in our case. The diagnosis of CD in small children can be hindered by an insufficient gluten-exposure, and can lead to a delay in the diagnosis as in the case presented above. |
format | Online Article Text |
id | pubmed-6392781 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-63927812019-03-15 Diagnostic challenges of celiac disease in a young child: A case report and a review of the literature Mărginean, Cristina Oana Meliţ, Lorena Elena Stefănuţ Săsăran, Vlăduţ Mărginean, Cristian Dan Mărginean, Maria Oana Medicine (Baltimore) Research Article RATIONALE: Celiac disease is a chronic, immune-mediated, multiorgan disorder that affects susceptible individuals, and it is triggered by gluten and other prolamins. PATIENT CONCERNS: We present the case of a 1-year-old male child, with a history of idiopathic pericardial effusion, admitted in our clinic for severe abdominal bloating, irritability, loss of appetite and intermittent diarrheic stools. The clinical findings were: influenced general status, irritability, distended abdomen, and diffuse abdominal tenderness. DIAGNOSES: The initial laboratory tests revealed anemia, leukocytosis, increased inflammatory biomarkers, high levels of transaminases, and hypoalbuminemia. The stool culture identified an enterocolitis with enteropathogenic Escherichia coli (E. coli). INTERVENTIONS: We initiated antibiotic treatment, substitution therapy with human albumin and probiotics with initial favorable evolution, but after 1 month, the patient was re-admitted for the persistence of intermittent diarrheic stools and abdominal bloating, when we established the diagnosis of cow's milk protein allergy. We initiated diary-free diet. OUTCOMES: Unfortunately, the patient was re-admitted after another 8 months, presenting the same clinical and laboratory findings as during the initial admission. We repeated the serology for celiac disease and we performed an upper gastrointestinal endoscopy with duodenal biopsies, which established the diagnosis of celiac disease. After 1 month of gluten-free diet, the patient's evolution improved considerably. LESSONS: Enterocolitis with E. coli could be considered as trigger for CD in our case. The diagnosis of CD in small children can be hindered by an insufficient gluten-exposure, and can lead to a delay in the diagnosis as in the case presented above. Wolters Kluwer Health 2018-06-01 /pmc/articles/PMC6392781/ /pubmed/29851812 http://dx.doi.org/10.1097/MD.0000000000010893 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 |
spellingShingle | Research Article Mărginean, Cristina Oana Meliţ, Lorena Elena Stefănuţ Săsăran, Vlăduţ Mărginean, Cristian Dan Mărginean, Maria Oana Diagnostic challenges of celiac disease in a young child: A case report and a review of the literature |
title | Diagnostic challenges of celiac disease in a young child: A case report and a review of the literature |
title_full | Diagnostic challenges of celiac disease in a young child: A case report and a review of the literature |
title_fullStr | Diagnostic challenges of celiac disease in a young child: A case report and a review of the literature |
title_full_unstemmed | Diagnostic challenges of celiac disease in a young child: A case report and a review of the literature |
title_short | Diagnostic challenges of celiac disease in a young child: A case report and a review of the literature |
title_sort | diagnostic challenges of celiac disease in a young child: a case report and a review of the literature |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392781/ https://www.ncbi.nlm.nih.gov/pubmed/29851812 http://dx.doi.org/10.1097/MD.0000000000010893 |
work_keys_str_mv | AT margineancristinaoana diagnosticchallengesofceliacdiseaseinayoungchildacasereportandareviewoftheliterature AT melitlorenaelena diagnosticchallengesofceliacdiseaseinayoungchildacasereportandareviewoftheliterature AT stefanutsasaranvladut diagnosticchallengesofceliacdiseaseinayoungchildacasereportandareviewoftheliterature AT margineancristiandan diagnosticchallengesofceliacdiseaseinayoungchildacasereportandareviewoftheliterature AT margineanmariaoana diagnosticchallengesofceliacdiseaseinayoungchildacasereportandareviewoftheliterature |